Johnson Bill Lets Colleges Offer Health Plans Outside Insurance Rules

The text as introduced · 832 words

89R1424 CJD-F

By: Johnson
H.B. No. 2290

A BILL TO BE ENTITLED

AN ACT

relating to health benefits offered by institutions of higher

education to students and their families.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

SECTION 1. Section 1275.002, Insurance Code, is amended to

read as follows:

Sec. 1275.002. APPLICABILITY OF CHAPTER. This chapter

applies only to:

(1) a health benefit plan offered by a nonprofit

agricultural organization under Chapter 1682; [ and ]

(2) a health benefit plan:

(A) that is a self-insured or self-funded plan

established by an employer for the benefit of the employer's

employees in accordance with the Employee Retirement Income

Security Act of 1974 (29 U.S.C. Section 1001 et seq.); and

(B) for which the plan sponsor has made an

election, submitted to the commissioner in the form and manner

prescribed by the commissioner, to apply this chapter to the plan

for the relevant plan year ; and

(3) a health benefit plan offered by an institution of

higher education under Chapter 1683 .

SECTION 2. Subtitle K, Title 8, Insurance Code, is amended

by adding Chapter 1683 to read as follows:

CHAPTER 1683. HEALTH BENEFITS PROVIDED BY CERTAIN INSTITUTIONS OF

HIGHER EDUCATION

Sec. 1683.001. DEFINITIONS. In this chapter:

(1) "Institution of higher education" means:

(A) an institution of higher education, as

defined by Section 61.003, Education Code; or

(B) a private or independent institution of

higher education, as defined by Section 61.003, Education Code.

(2) "Higher education health benefits" means health

benefits:

(A) sponsored by an institution of higher

education or an affiliate of the institution;

(B) offered only to:

(i) students enrolled at the institution of

higher education; and

(ii) family members of students enrolled at

the institution of higher education;

(C) that are not provided through an insurance

policy or other product the offering or issuance of which is

regulated as the business of insurance in this state; and

(D) that are deemed by the institution of higher

education to be important in assisting its students and their

families to live long and productive lives.

(3) "Preexisting condition" means a condition present

before the effective date of an individual's enrollment in higher

education health benefits.

Sec. 1683.002. HIGHER EDUCATION HEALTH BENEFITS

AUTHORIZED. An institution of higher education or an affiliate of

the institution may offer in this state higher education health

benefits.

Sec. 1683.003. WAITING PERIOD FOR PREEXISTING CONDITION.

Notwithstanding any other provision of this chapter, an institution

of higher education that offers higher education health benefits

may not require a waiting period of more than six months for

treatment of a preexisting condition otherwise included in higher

education health benefits.

Sec. 1683.004. REQUIRED DISCLOSURE FOR HIGHER EDUCATION

HEALTH BENEFITS. (a) An institution of higher education that

offers higher education health benefits must provide to an

individual applying for higher education health benefits written

notice that the benefits are not provided through an insurance

policy or other product the offering or issuance of which is

regulated as the business of insurance in this state.

(b) An individual must sign and return to the institution of

higher education the notice described by Subsection (a) before the

individual may enroll in higher education health benefits. The

institution of higher education must:

(1) maintain a copy of the signed written notice for

the duration of the term during which the higher education health

benefits are provided to the individual; and

(2) at the request of the individual, provide a copy of

the written notice to the individual.

Sec. 1683.005. INSTITUTION OF HIGHER EDUCATION NOT ENGAGED

IN BUSINESS OF HEALTH INSURANCE; REGISTRATION REQUIRED. (a)

Notwithstanding any other provision of this code, for the purposes

of offering higher education health benefits, an institution of

higher education that acts in accordance with this chapter is not a

health insurer and is not engaging in the business of health

insurance in this state.

(b) An institution of higher education that offers higher

education health benefits must register with the department and

provide information as needed to facilitate compliance with Chapter

1467, as applicable to those benefits under Section 1275.004.

Sec. 1683.006. RISK TRANSFER OR COVERAGE. An institution

of higher education that offers higher education health benefits

under this chapter may contract with a company authorized to engage

in the business of insurance in this state that is not under common

control with the institution of higher education to:

(1) transfer to that company all or a portion of the

organization's risks arising from higher education health benefits

offered under this chapter; or

(2) obtain insurance coverage from the company

guarantying the institution of higher education's obligations

arising from higher education health benefits offered under this

chapter.

SECTION 3. This Act takes effect immediately if it receives

a vote of two-thirds of all the members elected to each house, as

provided by Section 39, Article III, Texas Constitution. If this

Act does not receive the vote necessary for immediate effect, this

Act takes effect September 1, 2025.